Dental avulsion
Revision as of 15:40, 9 February 2015 by Rossdonaldson1 (talk | contribs) (Rossdonaldson1 moved page Tooth Avulsion to Tooth avulsion)
Contents
Background
- Dental emergency
- Tooth is completely removed from its socket
- Often associated with alveolar ridge fracture
Diagnosis
- Where is the tooth?
- It may be intruded, aspirated, swallowed, or embedded in the oral mucosa
- Consider facial films, CXR
- Additional Injuries?
- Age and head bleed risk?
Differential Diagnosis
Dentoalveolar Injuries
Odontogenic Infections
- Acute alveolar osteitis
- Acute necrotizing ulcerative gingivitis (trench mouth)
- Dental caries (pulpitis)
- Ludwig's angina
- Periapical abscess
- Pericoronitis
- Periodontal abscess
- Peritonsillar abscess (PTA)
- Retropharyngeal abscess
- Vincent's angina - tonsillitis and pharyngitis
Other
Management
- Adult
- Replace avulsed tooth as soon as possible (as long as no alveolar ridge fx, no severe socket injury)
- If reimplanted within 1hr 66% chance of good outcome
- Rinse (no scrubing!) tooth in saline, suction socket (if necessary), reimplant tooth, bond tooth to neighboring teeth
- Manipulate tooth only by the crown
- Storage solution (in order of efficacy): Hank's balanced salt solution > Milk > saliva > saline
- Penicillin or clindamycin
- Replace avulsed tooth as soon as possible (as long as no alveolar ridge fx, no severe socket injury)
- Child
- Do not re-implant primary teeth
- Increased risk of interference with the eruption of the permanent tooth[1]
- Refer to pedodontist for space maintainer
- Do not re-implant primary teeth
See Also
Source
- ER Atlas
- Tintinalli
- UpToDate